Drug Name Hydrocortisone Classification: glucocorticoid

Action Not clearly defined; may stabilize leukocyte lysosome membranes, suppress immune response, stimulate bone marrow, and influence nutrient metabolism. Reduces inflammation, suppresses immune function, and raises adrenocorticoid hormonal levels.

Indication Severe inflammation

Adverse Reactions CNS: euphoria, insomnia, seizures, CV: heart failure, hypertension, edema, arrhythmia, thromboembolism EENT: cataracts, pencreatitis Metabolic: muscle weakness, osteoporosis Skin: hirsutism, delayed wound healing, easy bruising

Nursing Responsibilities Monitor patients weight, blood pressure, and electrolyte levels. Be alert for any adverse reactions. For better results and lesser toxicity, give once daily dose in morning. Give oral dose with food. Give potassium supplements. Nursing Responsibilities Assess patients blood pressure or angina before therapy and regularly thereafter. Be alert for any adverse reactions. Advise patient to continue taking drug even when feeling well.

Drug Name Amlodipine besylate Classification: Antianginal, antihypertensive

Action Inhibits calcium ion reflux across cardiac and smooth muscle cells, thus decreasing myocardial contractility and oxygen demand. Also dilates coronary arteries and arterioles. Reduces blood pressure and prevents angina.

Indication Chronic stable angina HPN

Adverse Reactions CNS: headache, fatigue, somnolence CV: edema, dizziness, flushing, palpitations GI: nausea, abdominal pain, dyspepsia

Drug Name Salbutamol sulfate Dosage: Classification: bronchodilator

Action Relaxes bronchial smooth muscle by acting on beta2-adrenergic receptors. Improves ventilation.

Indication To prevent or treat bronchospasm in patients with reversible obstructive airway disease.

Adverse Reactions CNS: tremor, nervousness, dizziness, insomnia, headache CV: tachycardia, palpitations, hypertension EENT: drying and irritation of nose and throat GI: heartburn, nausea, vomiting Metabolic: hypokalemia, weight loss Musculoskeletal: muscle cramps Respiratory: bronchospasm

Nursing Responsibilities Obtain baseline assessment of patients respiratory status, and assess patient often during therapy. Be alert for any adverse reactions. If more than one dose is ordered, wait at least two minutes between nebulized doses. If corticosteroid inhaler is also used, first have patient use bronchodilator, wait 5 minutes, and then have patient use corticosteroid inhaler. This permits bronchodilator to open air passages for maximum effectiveness. Tell patient to reduce intake of foods and herbs containing caffeine, such as coffee, cola, and chocolate, when using a bronchodilator.

Drug Name Ceftazidime Classification: antibiotic

Action Inhibits cell-wall synthesis, promoting osmotic instability, usually bactericidal. Hinders or kills susceptible bacteria.

Indication Serious infections of lower respiratory tract

Adverse Reactions CNS: dizziness, headache, seizures GI: abdominal cramps, diarrhea, dyspepsia, nausea, pseudomembranous colitis, vomiting GU: candidiasis, genital pruritus Hematologic: agranulocytosis, eosinophilia, leucopenia, thrombocutosis Respiratory: dyspnea Skin: maculopapular and erythematous rashes, urticaria Other: elevated temperature, hypersensitivity, sterile abscesses, tissue sloughing at injection site, phlebitis, thrombophlebitis

Nursing Responsibilities Before giving first dose, ask patient about previous reactions to cephalosporins or penicillin. Be alert for any adverse reactions. If GI reactions occurs, monitor patients hydration. Inject deep into muscle mass, such as gluteus maximus or latrel aspect of thigh. Instruct patient to immediately report to prescriber any change in urinary output. Dose may need to be reduced to compensate for decresed excretion.

Drug Name Acetylcysteine Classification: mucolytic

Action Increases respiratory tract fluids to help liquefy tenacious secretions. Thins respiratory secretions.

Indication pneumonia

Adverse Reactions EENT: rhinorrhea, hemoptysis GI: stomatitis, nausea, vomiting Respiratory: bronchospasm

Nursing Responsibilities Be alert for any adverse reactions. Have suction equipment available in case p[atient cant effectively clear his air passage. Alert prescriber if patients respiratory secretions thicken or become purulent or if bronchospasm occurs. Inform patient that drug may have foul taste and smell. Instruct patient to clear his airway by coughing. Nursing Responsibilities Monitor patient for

Drug Name Celecoxib

Action May selectively inhibit cox-

Indication >for inflammation

Adverse Reactions CNS: dizziness, headache,,

: Classification: Anti-inflammatory

2, decreasing prostaglandin synthesis. Relieves pain and inflammation in joints and smooth tissue.

insomnia, stoke CV: hypertension, MI, peripheral edema EENT: pharyngitis, rhinitis, sinusitis GI: abdominal pain, diarrhea, dyspepsia, flatulence, nausea Metabolic: hyperchloremia, hypophosphatemia Musculoskeletal: back pain Respiratory: upper resoiratory tract infection Skin: erythema multiforme, exfoliative dermatitis rash, StevensJohnson Syndrome, toxic epidermal necrolysis Other: accidental injury

evidence of overt and occult bleeding. Monitor patient for signs and symptoms of liver toxicity. Although drug can be given with or without food, food may decrease GI upset. Rehydrate patient before therapy. Advise patine to immediately report to prescriber rash, unexplained weight gain, or edema. Instruct patient to take drug with food if Gi upset occurs. Inform patient that if it may take several days before he feels consistent pain relief.

Drug Name Omeprazole Classification: Proton pump inhibitor

Action Inhibits acid (proton) pump and binds to hydrogen-potassium adenosine triphosphate on secretory surface of gastric parietal cells to block formation of gastric acid.

Indication >for peptic ulcer

Adverse Reactions CNS: dizziness, headache GI: abdominal pain, diarrhea, nausea, vomiting, constipation, flatulence Musculoskeletal: back pain Respiratory: cough Skin: rash

Nursing Responsibilities Assess patients condition before starting therapy. Be alert for any adverse reactions. If adverse GI reaction occurs, monitor

Relieves symptoms caused by excessive gastric acid.

patients rehydration. Give tablets or capsules 30 minutes before meals. Warn patient not to crush or chew tablets or capsules.

DRUG NAME Generic name: CLONIDINE Brand names: Catapres, CatapresTTS, Dixarit, Duraclon

CLASSIFICATION Antihypertensive

ACTION Stimulates alphaadrenergic receptors in the CNS; which results in decreased sympathetic outflow inhibiting cardioacceleration and vasoconstriction centers. Prevents pain signal

INDICATIONS PO, Transdermal: management of mild to moderate hypertension.

ADVERSE EFFECTS CNS: drowsiness, depression, dizziness, nervousness, nightmares. CV: bradycardia, hypotension,(increased with epidural), palpitation GI: dry mouth, constipation, nausea, vomiting GU: erectile dysfunction DERM: rash, sweating

NURSING RESPONSIBILITY Monitored blood pressure and pulse frequently during initial dosage adjustment and periodically throughout therapy. Observed patient for tolerance to drugs therapeutic effects, which may require

transmission to the CNS by stimulating alpha-adrenergic receptors in the spinal cord.

F and E: sodium retention METAB: weight gain MISC: withdrawal phenomenon.

increased dosage. Advised patient that stopping drug abruptly may cause severe rebound high blood pressure. Told patient to take the last dose immediately before bedtime. Caution patient that drug may cause drowsiness but that this adverse effect usually diminishes over 4 to 6 weeks. Informed patient that dizziness upon standing can be minimized by rising slowly from a sitting or lying position and avoiding sudden position changes.